Provider Demographics
NPI:1558028811
Name:MJDDDS, PLLC
Entity Type:Organization
Organization Name:MJDDDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:DRESCHER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-922-1311
Mailing Address - Street 1:3155 BOOK RD STE 107
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9546
Mailing Address - Country:US
Mailing Address - Phone:630-922-1311
Mailing Address - Fax:630-922-4212
Practice Address - Street 1:3155 BOOK RD STE 107
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9546
Practice Address - Country:US
Practice Address - Phone:630-922-1311
Practice Address - Fax:630-922-4212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental